UNITED INDIA INSURANCE CO LTD Vs. MEHTAB SINGH

JUDGEMENT

(1.) respondent had taken a medi-claim insurance policy from the appellant for a period of one year. The claim of the respondent for a sum of Rs.65,000/- spent by him was repudiated by the appellant on the ground that the respondent had concealed pre-existing disease and was, therefore, not entitled to any claim. Vide impugned order dated 24.3.1998 passed by the District Forum the claim of the respondent was allowed with interest @ 18% p. a.

(2.) The solitary plea taken by the appellant while assailing the impugned order is that the District Forum did not take into account the opinion of Dr. Vipin Gupta (Annexure R-4) by observing that the appellant has failed to either produce Dr. Vipin Gupta or the fact that the opinion was actually given by Dr. Vipin Gupta. The opinion of Dr. Vipin Gupta produced by the appellant is as under: "as per my opinion the present case is not within the purview of mediclaim policy since the disease is pre-existing. Insured had taken the present policy from the under writers for the first time on 14.3.1997. He cannot develop the disease of such severity in just four months. He must be having present disease for many years.

(3.) Admittedly Dr. Vipin Gupta was not the person who had either examined the respondent or given him the treatment. He was merely on the panel of the appellant and gave the opinion on perusal of the record of the treatment provided by Kalra Hospital of Kirti Nagar, New Delhi.